| NPI | 1861478869 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WA 3911) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: ID ODP-100061) |
| 152W00000X Optometrist (Licence: OR 2970AT) | |
| Enumeration Date | 2005-12-21 |
| Last Update Date | 2021-09-17 |